title: [Exclusive radiotherapy of locally advanced carcinoma of the larynx. Analysis of the caseload of Varese (1979-1986)].
abstract: The authors analyse a retrospective series of 90 consecutive patients (pts) affected with locally advanced laryngeal carcinoma (T3-4, N0-3--TNM, UICC 1978) who were radically irradiated from November 1979 to December 1986 at the Radiotherapy Department of the General Hospital of Varese. All the patients were treated with 60Co and two opposed parallel lateral fields and progressive shrinkage: 66 with conventional fractionation (2 Gy once a day, 5 times a week), 24 with an accelerated hyperfractionated regimen (1.5 Gy twice a day, 5 times a week). The median total dose delivered to the tumor and clinically involved nodes was 64 Gy (1678 reu, CRE). Median follow-up was 21 months (range: 3-113). The 5-year overall survival (Kaplan-Meier) was 40.5%. The 5-year disease-free survival, for 47 patients in complete remission at the end of radiotherapy, was 51.9% after irradiation alone and 56.7% with salvage surgery. There were no statistically significant differences in survival according to local spread (T3 vs. T4), nodal status (N0 vs. N1-3) and dose fractionation regimen (conventional vs. accelerated hyperfractionated). Isoeffect (CRE) values above 1751 reu obtained a 3-year loco-regional control rate of 65%, while, for isoeffect values under 1600 reu, the 3-year loco-regional control rate was 33.3%. Relevant late sequelae were not observed. Our findings suggest that primary radiotherapy with salvage surgery in reserve could be considered as an effective choice for locally advanced laryngeal carcinoma, at least in selected groups of patients.
authors.affiliation: Divisione di Radioterapia, Ospedale Multizonale, Varese.
authors.forename: P
authors.initials: P
authors.lastname: Antognoni
authors.forename: A
authors.initials: A
authors.lastname: Bossi
authors.forename: M
authors.initials: M
authors.lastname: Molteni
authors.forename: A
authors.initials: A
authors.lastname: Richetti
authors.forename: M
authors.initials: M
authors.lastname: Tordiglione
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007558:Italy; D007822:Laryngeal Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011832:Radiation Injuries; D012074:Remission Induction; D012189:Retrospective Studies; D015996:Survival Rate
vernacular_title: La radioterapia esclusiva dei carcinomi laringei in stadio localmente avanzato. Analisi della casistica di Varese (1979-1986).